- 期刊
牙周再生術是真理或虛構幻象？
Is Guided Tissue Regeneration Still a Truth or a Fiction?
摘要
牙周病是牙齒的附連組織(attachment tissues)受到致病菌感染而破壞，若不及早妥當治療加上正確的定期保養，最終會導致牙齒之喪失。牙周組織再生術(GTR)用於修護牙周骨缺損，齒根叉病變和委縮型缺陷(recession defects)治療程序，以重建牙周組織結構（牙梅、齒槽骨、牙骨質和牙周韌帶）和生理功能。這種治療方法自19 80年代Dr. Nyman 等學者創新開發以來已經有數十年研究和臨床應用。到底實證醫學和長期療效結果如何文獻上頗有爭議？本精簡文獻回顧將分段詳細討論，從最近所有實證科學證據（動物或是臨床人體實驗）結合優質Systematic Review內容去討論一些研究設計良好的GTR研究結果，給大家針對此議題的現況有一全面性的了解，同時解答為什麼“牙周再生術”仍是臨床上挽救牙齒和牙周病治療的一則良方。
並列摘要
Periodontitis is a chronic bacterial infection that leads to destruction of the tooth-attachment apparatus and its supporting bone. If periodontitis-affected teeth remain untreated, it will result in progressive attachment tissue loss that eventually leads to tooth loss. According to an official viewpoint from the American Academy of Periodontology, definition of periodontal regenerative procedures (guided tissue regeneration, GTR) are used to treat periodontal osseous, furcation and recession defects, and restore the architectures and function of the lost or injured tissues. This means that the structures (gingival, periodontal ligament, cementum and bone) and function (connection of periodontal ligament fiber attachment to the root surface for mastication) of the periodontal tissues should be restored. Since the pioneer work created by S. Nyman, Gottlow and Karring in 1980, GTR procedures have been extensively studied and applied clinically for over 20-30 years. Whether is there enough scientific evidence or the results of long-term clinical follow-up, is still subjected to controversy clinically. Therefore, this short concise paper will summarize and discuss current evidence-based literature (preclinical animal studies) and randomized, long-term (over 10 years) controlled clinical investigations. This not only provides an up-to-date overview of this issue; and also in an attempt to answer the question, does periodontal tissue regeneration really work or is only a fictitious story? Is this technique still an effective method in saving teeth and treating periodontal disease?